文章摘要
姜玉,张建富,王 蓉,吴雨洁,卢绪章.外周血涂片中涂抹细胞与幼稚淋巴细胞的比例在慢性淋巴细胞白血病中的意义[J].南京医科大学学报,2014,(4):495~498
外周血涂片中涂抹细胞与幼稚淋巴细胞的比例在慢性淋巴细胞白血病中的意义
Significance of smudge cells and prolymphocytic cells on peripheral blood smear in chronic lymphocytic leukemia
投稿时间:2013-07-08  
DOI:10.7655/NYDXBNS20140419
中文关键词: 涂抹细胞  幼稚细胞  ZAP70  CD38  慢性淋巴细胞白血病
英文关键词: smudge cell  prolymphocytic cell  ZAP70  CD38  CLL
基金项目:南京医科大学“十二五”教育研究课题(NY222201339)
作者单位
姜玉 南京医科大学附属常州市第二人民医院血液实验室,江苏常州213000 
张建富 南京医科大学第一附属医院血液研究所,江苏南京210029 
王 蓉 南京医科大学第一附属医院血液研究所,江苏南京210029 
吴雨洁 南京医科大学第一附属医院血液研究所,江苏南京210029 
卢绪章 南京医科大学附属常州市第二人民医院血液实验室,江苏常州213000 
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中文摘要:
      目的:探讨外周血涂片中涂抹细胞占淋巴细胞的比例和幼稚淋巴细胞占淋巴细胞的比例预测慢性淋巴细胞白血病预后的价值?方法:每例患者计数外周血涂片中200个淋巴细胞,计算涂抹细胞?幼稚淋巴细胞占淋巴细胞的比例?同时用流式细胞仪检测外周血中ZAP-70?CD38阳性细胞在CD5+CD19+淋巴细胞中的比例,分析涂抹细胞?幼稚细胞与细胞表达ZAP70?CD38的相关性?结果:在53例慢性淋巴细胞白血病患者中,涂抹细胞的比例为24.5%(1%~65%),幼稚细胞的比例为5.3%(1%~51%),涂抹细胞的比例和幼稚细胞的比例呈负相关(r = -0.317, P = 0.021)?在ZAP70阳性的11例(20.5%)患者中,涂抹细胞的比例明显低于ZAP70阴性的患者(P = -0.046),而幼稚细胞比例则高于ZAP70阴性的患者(P = 0.002),涂抹细胞比例和ZAP70表达呈负相关(r = -0.782,P = 0.004)?在CD38阳性15例(28.3%)患者中,涂抹细胞的比例低于CD38阴性的患者(P = 0.024),而幼稚细胞则高于CD38阴性的患者(P < 0.001),幼稚细胞比例和ZAP70?CD38均呈正相关(ZAP70:r = 0.685,P = 0.020;CD38:r = 0.575,P = 0.025)?结论:慢性淋巴细胞白血病患者外周血中涂抹细胞?幼稚细胞?ZAP70和CD38的表达基本一致,其中检测涂抹细胞和幼稚细胞比例的操作简单易行,在未开展流式细胞仪检测的基层可以作为预测慢性淋巴细胞白血病预后的指标?
英文摘要:
      Objective:To study the proportion of smudge cells and prolymphocytic cells in lymphocytes from peripheral blood smear to predict prognosis value of chronic lymphocytic leukemia (CLL). Methods:We counted 200 lymphocyte in each patient’s routine blood smear,and calculated the proportion of smudge cells and prolymphocytic cells in lymphocytes. We detected the expression of ZAP70 or CD38 among CD5+CD19+ cells by flow cytometry. We analyzed the correlation of smudge cells,prolymphocytic cells,ZAP70+ cells and CD38+ cells. Results:In 53 patients with CLL,the median percentage of smudge cell was 24.5% (1%~65%),the median percentage of prolymphocytic cell was 5.3% (1%~51%). Smudge cells were negatively related to prolymphocytic cells (r = -0.317,P = 0.021). The proportion of smudge cells in 11 patients with ZAP70+ was significantly lower than that in patients with ZAP70- (P = -0.046),and the proportion of prolymphocytic cell was higher than that in patients with ZAP70- (P = 0.002),smudge cells proportion was negatively correlated with ZAP70- expression (r = -0.7818,P = 0.004). In 15 patients with CD38+,the proportion of smudge cells was lower than that in patients with CD38-(P = 0.024),and the proportion of prolymphocytic cells was higher than that in patients with CD38-(P < 0.001),the proportion of prolymphocytic cells was positively correlated with ZAP70 or CD38 expression (ZAP70:r = 0.685,P = 0.020;CD38:r = 0.575,P = 0.025). Conclusion:In CLL patients,smudge cells or prolymphocytic cells on peripheral blood smear and expression of ZAP70 and CD38 in peripheral blood were the same. The detection of smudge cells and prolymphocytic cells on peripheral blood smear is simple and easy,it can be used as a prognostic indicator of CLL patients in basic hospital which did not carry out flow cytometry.
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